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Contents

Vaccine preparation.............................................................................. 2

Adult ...................................................................................................... 3

Antenatal vaccination protocol: Pertussis and influenza (Adult) .............................. 3

Key points ...................................................................................................................... 3 Contraindications ........................................................................................................... 4 Discussion and informed consent .................................................................................. 4 Administration ................................................................................................................ 4 Management of anaphylaxis .......................................................................................... 5

Measles, mumps & rubella (MMR) vaccine administration (Adult) .......................... 6

Key points ...................................................................................................................... 6 Procedure ...................................................................................................................... 8 Contraindications1 .......................................................................................................... 8 Precautions1................................................................................................................... 9 Side effects of MMR vaccine1 ........................................................................................ 9

Neonatal .............................................................................................. 10

Hepatitis B vaccine: Neonatal administration ........................................................ 10

Key points .................................................................................................................... 10 Prior to administering the HBV vaccine ........................................................................ 10 Administration of the HBV vaccine ............................................................................... 10 Documentation ............................................................................................................. 11 Postnatal education ..................................................................................................... 11

Hepatitis B immunoglobulin (HBIG): Neonatal ...................................................... 12

Dosage ........................................................................................................................ 12

References .......................................................................................... 13

CLINICAL PRACTICE GUIDELINE

Vaccinations This document should be read in conjunction with this Disclaimer

Vaccinations

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Vaccine preparation

Ensure that the minimum / maximum thermometer displays temperatures within

the +2ºC to +8ºC range before removing the vaccine from the refrigerator.

Ensure that the correct vaccine (check against the prescription) is taken from

the refrigerator and that it is within expiry date.

Check that there is no particulate matter or colour change in the vaccine.

Prepare the appropriate injection equipment for the vaccine to be administered.

Do not push small air bubbles through the needle for injection. In the rare

instance of a large air bubble in a pre-filled syringe, first draw back on the

needle to ensure no vaccine is expelled along with the air, and then expel the

air through the needle, taking care not to prime the needle with any of the

vaccine, as this can lead to increased local reaction.

For more details on preparation, administration (injection sites and

techniques) or procedures after vaccination, see the Australian Immunisation

Handbook: Vaccination Procedures.

Reference1

See also Public Health Take 5 on Managing a Cold Chain Breach (available

to WA Health staff through Healthpoint)

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Adult

Antenatal vaccination protocol: Pertussis and influenza (Adult)

Key points

1. Check beforehand that the vaccination has not already been given by another

service.

2. The pertussis vaccine and influenza vaccine are not live vaccines.

3. Vaccination with influenza and dTpa is recommended with each pregnancy to

provide maximum protection to every infant; this includes pregnancies which

are closely spaced (e.g. < 2 years).

4. The vaccines may only be administered by:

A Medical Practitioner

A Registered Nurse or Midwife (includes PG midwifery students but

excludes undergraduate midwifery or nursing students)

5. A Registered Nurse / Midwife may administer the vaccine at KEMH with a

written medication order provided the consent form has been completed and

is present with the medical notes.

6. Registered Nurses / Midwives who meet the requirements of the relevant

Chief Executive Officer of Health Structured Administration and Supply

Arrangements (SASA) may administer these vaccines at KEMH without a

formal written medical order. See Registered Nurses – vaccination (Word

91KB) and Midwives – vaccination (Word 90KB) for requirements.

7. The person administering the vaccines(s) must complete the administration

section of the consent form following administration. The original must be filed

in the woman’s medical notes.

8. Read Department of Health WA: OD: 0600/15 Influenza and Pertussis

Vaccinations for Pregnant Women for background information.

9. Influenza: Influenza vaccination can be administered at any time during

pregnancy.1 See Department of Health WA:

Immunisation Schedule (external website)

Influenza Immunisation Program (external website).

10. Pertussis:

The recommendation for pertussis vaccination has been updated

(May 2019). Pertussis vaccination will be offered to all antenatal

women, (mid 2nd trimester to early 3rd trimester) with optimal timing 20-

32 weeks gestation.1

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20-32 weeks gestation is the optimal time for administration of

pertussis vaccination (diphtheria, tetanus and pertussis) dTPa,

however if not vaccinated during this time, they should receive the

vaccine as soon as possible and at any time during the third trimester

up to birth. If given within two weeks of birth, the newborn may not be

adequately protected.1

Women who have a preterm birth prior to receiving the pertussis vaccine

i.e. <28-32 weeks should be offered pertussis vaccination prior to

postnatal discharge.

If women receive the vaccine earlier than 20 weeks, they do not need a

repeat dose in the same pregnancy.1

Partners and family members are not eligible to participate in the WA

Health Pertussis in Pregnancy Programme but should be advised to

consider vaccination via their nominated healthcare provider.

Contraindications

Pertussis: Previous life threatening allergic reaction after any pertussis, tetanus

or diphtheria containing vaccine or severe allergy to any part of the vaccine.

Influenza: Previous life threatening allergic reaction after a dose of influenza

vaccine or severe allergy to any part of the vaccine.

Discussion and informed consent

Discussion about Pertussis and Influenza vaccination should occur as part of

routine antenatal care late in the second trimester and during the early third

trimester.

All women must be provided with a copy of the Pertussis Vaccine in

Pregnancy (ViP) and the Influenza ViP leaflets.

The risks and benefits of vaccination must be discussed.

If after discussion, the woman choses to participate in either or both of the

programmes she must complete the ‘Antenatal Vaccination Authorisation and

Consent Form’ prior to the vaccines’ administration

See also Department of Health WA: Consent Process For Vaccination

Administration

See Pharmacy guidelines: Pertussis Vaccine and Medication Administration

Prior to administration the two people checking and administering the

vaccine(s) must ensure the woman has completed and signed the “Antenatal

Vaccination Consent Form”

Refer to section: Vaccine Preparation above

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The procedure for checking and administering the vaccine(s) shall be as per

clinical guideline Schedule 4 Prescription Only Medication Administration

The vaccine(s) must be administered intramuscularly into the deltoid muscle

of either arm. It must not be administered into the buttocks or thigh.

If two vaccines are to be given, they must be administered as separate

injections. If required, they can be given in the same arm separated by 2.5cm

from the initial injection site. The location of each vaccine administration is to

be documented on immunisation sticker and consent form.

IM administration should be given with care in women suffering from

coagulation disorders due to the risk of haemorrhage. In these circumstances

administration by deep subcutaneous injection may be considered, although

there is a risk of increased local reactions.

Following administration the person administering the vaccine(s) must

complete the Antenatal Vaccination Authorisation and Consent form with the

details of the vaccines used and the form scanned and emailed to the CDCD

at antenatal.immunisation@health.wa.gov.au .

A KEMH antenatal vaccination sticker must also be completed and placed in

the medical notes on the MR004 Special Instructions Sheet.

Documentation:

The vaccine vials/ pre-filled syringe each have 2 identification stickers

which may be used in completing the documentation.

Staff vaccinating under the relevant SASA are required to document

immunisations on the Australian Immunisation Register (AIR).

If following receipt of the information sheets and discussion, a woman declines

vaccination, a KEMH ‘Declined Antenatal Vaccination’ sticker must be completed

and placed on the MR004 Special Instruction sheet in the medical notes.

Post vaccination care

The vaccinated person should be advised to remain in the vicinity for a

minimum of 15 minutes after the vaccination. The area should be close

enough so that the vaccinated person can be observed and medical treatment

provided rapidly if needed.

Management of anaphylaxis

Manage as per Clinical Guidelines:

Anaesthetics: Anaphylaxis (access for WA Health employees through

Healthpoint)

Obstetrics & Gynaecology: Clinical Deterioration

See also NMHS, Metropolitan Communicable Disease Control: Anaphylaxis: A

Guide for Healthcare Workers Influenza Program Vaccinators (2019)

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Measles, mumps & rubella (MMR) vaccine administration (Adult)

Aims

The prevention of congenital malformations due to rubella infection in a

subsequent pregnancy.

To inform clinical staff of the key points, procedure, contraindications,

precautions and side effects relevant to administration of the measles, mumps

and rubella (MMR) vaccine.

Background

Maternal rubella infection in the first trimester of pregnancy can result in fetal

infection and malformations in up to 90% of affected pregnancies. Rubella outbreaks

in populations that are vaccinated against rubella are rare.1 Fetal damage after 16

weeks is rare but has been reported up to 20 weeks gestation. The number of cases

of congenital rubella syndrome (CRS) has fallen rapidly since rubella vaccine

licensure in Australia.1 Maternal rubella infection can result in severe congenital

abnormalities and fetal demise.

Key points

1. Rubella immunity should be determined for every pregnancy and testing

should be offered at the first antenatal appointment. If non immune, women

can then be offered vaccination after the birth to provide protection against

rubella infection and related fetal malformations in future pregnancies.2

2. Every effort should be made to identify non-pregnant, non-immune women of

child bearing age and provide the MMR vaccine.1

3. The following women are more likely to be non-immune/ seronegative to

rubella1:

Aboriginal and Torres Strait Islander women living in rural or remote

regions2

Women born overseas (particularly in Asia, Pacific Islands, sub-

Saharan Africa and South America) who have entered Australia after

the age of routine vaccination are twice as likely to be non-immune

than Australian-born women2

Non-English speaking women

Women over the age of 35 (possibly due to declining immunity)2

Australian-born Muslim women.1

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4. Women found to be seronegative on antenatal rubella immunity testing should be

offered the MMR vaccine after giving birth and before discharge1 from KEMH.

5. Adult MMR is on the WA vaccination schedule (PDF 129KB) where <2 doses

MMR received.

6. Adult rubella vaccination is only available as the MMR, as there is no

monovalent rubella vaccine in Australia. MMR with varicella (MMRV) is not

appropriate for women aged >14 years and is only used as a single dose at

18 months of age.1

7. Co-administration with other injections

Rh (D) immunoglobulin (anti-D) does not interfere with the antibody

response to the vaccine. If anti-D is also required, the two may be

given at the same time in different sites with separate syringes, or at

any time in relation to each other.1

MMR vaccine can be given simultaneously with other live attenuated

parenteral vaccines (e.g. varicella vaccine) and other inactivated

vaccines using separate syringes and injecting sites. Vaccines must

not be mixed together in a single syringe. If live vaccines are not given

simultaneously they should be given at least 4 weeks apart.1

8. Breast feeding is not a contraindication to rubella vaccine.3, 4 The rubella

virus may be secreted in breast milk and transmitted to neonates, however

the attenuated virus is well tolerated4, with mild or absent symptoms in

situations where infection has occurred.1

9. There is no risk to pregnant women from contact with recently vaccinated

individuals with MMR vaccine. The vaccine virus is not transmitted from

vaccinees to susceptible contacts.1

10. If the woman has become pregnant within 28 days of a MMR vaccine, inform

her that the fetus is unlikely to have been affected by the vaccine.1, 2

Who should not have the vaccine?

Before being vaccinated, ask the woman if they:

aren’t feeling well (for example you have a fever)

have any severe allergies (such as antibiotics, latex, gelatine)

are pregnant or plan to be pregnant in the next 2 months

have received another live vaccination in the last month

have received blood, blood products or immunoglobulin in the last 3 months

have a disease (for example HIV/AIDS or cancer) or having treatment that

lowers immunity.

Ref: http://healthywa.wa.gov.au/Articles/J_M/Measles-mumps-rubella-MMR-

vaccine

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Procedure

1. Ensure the woman understands the reasons for vaccination as soon as she is

no longer pregnant4, and gain her informed consent prior to administration.

2. Confirm by sighting pathology results that the woman’s rubella immunity level

is low, and check for allergies and contraindications prior to administration.

3. Refer to section: Vaccine Preparation above

4. If the skin is not visibly clean, wipe the site with an alcohol wipe and allow to

dry (alcohol can inactivate the viruses in the vaccine).5

Whether administration is intramuscular (IM) and / or subcutaneous

(SC) is dependent on the individual MMR brand, see vaccine vial and

administer accordingly.1

5. After administration, document on the woman’s medication chart (MR810). In

the medical record document the following:

Date and time of administration, and

Manufacturer and batch number.

6. Provide the woman with the KEMH MMR vaccination letter. All women

receiving the MMR vaccine must be counselled about the need to avoid

becoming pregnant for 28 days after vaccination1. Women who have

received the MMR vaccination must be advised that they should be tested for

rubella immunity 6-8 weeks after vaccination.1, 3 Women who are non-

immune after vaccination are recommended to receive a second dose1 Levels

that remain low after a second documented vaccination are unlikely to

increase with further vaccinations.1

Contraindications1

Allergy to vaccine components:

Anaphylaxis following a previous dose of rubella, MMR or MMRV or

Anaphylaxis following any vaccine component.5

People who are immunocompromised.3, 5 This includes women :

who are significantly immunocompromised because of a medical

condition(s)

receiving high dose systemic immunosuppressive therapy, such as

chemotherapy, radiation therapy or oral corticosteroids

See section Vaccination for People who are Immunocompromised in

the Immunisation Handbook for more details

Pregnancy5; pregnancy should be avoided for 28 days after receiving the live

MMR vaccine.4 If the woman becomes pregnant in this period, she should be

counselled by her medical practitioner. No evidence of vaccine induced

Congenital Rubella Syndrome has been reported. Based on this evidence the

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vaccine cannot be considered teratogenic and termination of pregnancy

following inadvertent vaccination is not indicated.

Precautions1

Vaccination after receiving immunoglobulin or a blood product

A recent blood transfusion with washed red blood cells is not a

contraindication to MMR vaccine

Rubella containing vaccine should not be given within at least 3-11

months after administration of an immunoglobulin-containing blood

product e.g. packed red blood cells, whole blood transfusion,

immunoglobulin (except anti-D; see key point 6 above), or other

antibody-containing blood products (e.g. plasma or platelet products),

because the expected immune response may be impaired, with

vaccine failure due to passively acquired MMR antibodies.5

More specific guidance of vaccine deferral periods depending on the

type of blood products received by the woman is available in the

Australian Immunisation Handbook:

o Table of Recommended intervals between immunoglobulins or

blood products, and MMR, MMR-V or varicella vaccination and

o Vaccination for people who have recently received normal

human immunoglobulin and other blood products.

Refer to the Australian Immunisation Handbook for advice regarding

vaccination in the context of recent or future blood product administration,

immunosuppression/compromise, HIV, and corticosteroid therapy.

Household contacts of people who are immunocompromised can safely

receive MMR as it is not transmissible from vaccinated people to others

People with a history of thrombocytopenia. Thrombocytopenia is a rare

adverse event after MMR vaccination.

Side effects of MMR vaccine1

Inform women about possible symptoms occurring 5-12 days after vaccination

and how to manage the symptoms including using paracetamol for fever.

Note- Paracetamol should not be given for more than 48 hours without

seeking medical advice.

7-10 days (range 5-12 days) after injection:

Fever lasting 2-3 days that may be associated with malaise, faint red

rash (not infectious).

An increased risk for febrile seizures of about 1:3000-4000 doses in

same time period

See Immunisation Handbook: Rubella: for adverse events

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Neonatal

Hepatitis B vaccine: Neonatal administration

See also Neonatal Postnatal Ward guideline: Maternal Hepatitis B Virus (HBV): Care

of the infant born to HBV positive woman and HB Immunoglobulin (in this document)

if the neonate is born to a mother who is HBV positive.

Key points

1. All neonates should be offered hepatitis B vaccination.

2. The birth dose should be given when the neonate is physiologically stable,

preferably within 24 hours of birth.1

3. The first birth dose of hepatitis B vaccine should not be delayed beyond 7

days of birth.1, 6

4. Neonates (term or preterm) of hepatitis B carrier mothers should be given a

birth dose of hepatitis B vaccine (Paediatric) and paediatric dose of hepatitis B

immunoglobulin (HBIG) given on the day of birth at the same time but in

separate thighs.1 See next chapter ‘Hepatitis B immunoglobulin (HBIG):

Neonatal’ for details if HBIG is required.

5. Refer to “Neonatal Medication Administration” (page 6) ‘Competency

Requirements’ in clinical guideline, Pharmacy, Medication Administration

(available to WA Health employees via Healthpoint).

Prior to administering the HBV vaccine

Check that the MR 216 Consent for Hepatitis B Immunisation form is signed

by the mother.

Ensure the dosage is written up by a doctor on the MR 811 Neonatal Inpatient

Medication Chart.

Check that the identification name bands on the neonate and mother

correspond with the consent form and medication chart.

Administration of the HBV vaccine

Refer to section: Vaccine Preparation

Prepare the site

The vastus lateralis muscle in the anterolateral thigh is the recommended site

for IM vaccination in infants < 12 months of age, due to its larger muscle size.

If the site is soiled in any way, clean the site with soap and water.

If the mother has a known blood borne virus, ensure the limb is cleaned

with soap and water prior to vaccination.

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If HBIG is required for maternal HBV- it to be administered concurrently

therefore both limbs are to be cleaned.

For infants the preferred needle size is 25mm. If using a 25 gauge needle for

an IM injection, ensure the vaccine is injected slowly over a count of 5

seconds to avoid injection pain and muscle trauma.

Administration

Administer sucrose / breastfeed at the time of injection.

Ensure the neonate does not move during the IM injection. However excessive

restraint can increase the neonate’s fear and can result in increased muscle

tension.

Pierce the skin at an angle of 90º to the skin so the needle can safely be

inserted to the hub. Provided an injection angle of > 70º is used, the needle

should reach the muscle layer.

If you have drawn back on the syringe plunger before injecting a vaccine

(which is not considered necessary) and a flash of blood appears in the

needle hub, withdraw the needle and select a new site for injection.

Documentation

Record administration on the:

MR 811 Neonatal Inpatient Medication Chart- place small batch sticker on the

dedicated “pharmacy” box of the drug chart.

Baby’s Personal Health Record (purple book) birth details on page 33 and

immunisation record card.

MR 410 Neonatal History.

MR 425.10 Care of the Well Neonate Chart.

Postnatal education

Inform the woman of the schedule for hepatitis B immunisation

Provide information about known side-effects that may occur following vaccination.

Refer parents to the Vaccination booklet in the back of the purple book.

Adverse events after vaccination are transient and minor and may include

soreness of the injection site. Fever may occur in neonates after immunisation,

(0.6-3.7%).1

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Hepatitis B immunoglobulin (HBIG): Neonatal The section below must be read in conjunction with the Neonatal Postnatal Ward

guideline: Maternal Hepatitis B Virus (HBV) which contains background, key points,

management and GP follow-up. The section below contains administration details only.

Dosage

The dose of HBIG is 100IU units to be given by intramuscular injection (IMI).1

Prior to administering the immunoglobulin

Check consent, identification and prepare as per previous section “Prior to

administering” neonatal HBV vaccine.

The order of HBIG is also written by the doctor on the MR 811 Neonatal

Inpatient Medication Chart. The midwife telephones the haematology Blood

Bank to request the HBIG; then sends or arranges for a neonatal

identification sticker label to be taken to the lab for HBIG to be dispensed.

Refer to section: Vaccine Preparation above

Administration of the immunoglobulin

Follow section above: Hepatitis B Vaccine: Neonatal Administration

Administration of the HBIG is given at the same time as the first dose of

thiomersal-free monovalent hepatitis B vaccine; within 12 hours of birth in a

different thigh.1

The limbs must be cleaned with soap and water prior to administration.

Note: If concurrent administration is not able to be done, vaccination should not

be delayed beyond 7 days after birth.

Postnatal Education and Documentation – document HBIG as per Neonatal

Hepatitis B Vaccine in previous section

See Neonatal Postnatal Ward guideline: Maternal Hepatitis B Virus (HBV): Quick

Reference Guide for additional details

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References

1. Australian Technical Advisory Group on Immunisation (ATAGI). The Australian immunisation handbook (2019 update)Canberra: Australian Government Department of Health; 2019. Available from: https://immunisationhandbook.health.gov.au

2. Department of Health. Clinical Practice Guidelines: Pregnancy Care. Canberra: Australian Government Department of Health; 2018. Available from: https://beta.health.gov.au/resources/publications/pregnancy-care-guidelines

3. Australian Medicines Handbook [Internet]. Measles, mumps and rubella vaccine. 2019. Adelaide (South Australia): Australian Medicines Handbook. Available from: https://amhonline-amh-net-au.kelibresources.health.wa.gov.au/chapters/vaccines-chap/vaccines/measles-mumps-rubella-vaccine?menu=hints

4. Advisory Committee on Immunization Practices (ACIP). Guidelines for vaccinating pregnant women. [Internet].Atlanta (Georgia): Centers for Disease Control and Prevention; 2016. Available from: https://www.cdc.gov/vaccines/pregnancy/hcp/guidelines.html

5. MIMS Australia. Priorix. 2019. St Leonards (NSW, Australia): MIMS Online. Available from: https://www-mimsonline-com-au.kelibresources.health.wa.gov.au/Search/FullPI.aspx?ModuleName=Product%20Info&searchKeyword=priorix&PreviousPage=~/Search/QuickSearch.aspx&SearchType=&ID=41070001_2

6. Trung A, Walker S, Women's Health Committee. Management of hepatitis B in pregnancy. C-Obs 50 [Internet]. Melbourne (Victoria): Royal Australian and New Zealand College of Obstetricians and Gynaecologists [RANZCOG]; 2016 [cited 2018 April 2]. Available from: https://www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Management-of-Hepatitis-B-in-Pregnancy-(C-Obs-50)-Review-July-2016.pdf?ext=.pdf

Related policies and legislation

Legislation - Commonwealth Family Law Act 1975; Poisons Act 1964

Policies- Government of Western Australia- Department of Health:

Operational Directive (OD) 0657/16: WA Health Consent to Treatment Policy 2016

(Parental Consent within 4.3.2 Children and young people p.16)

OD 0600/15 - Influenza and Pertussis Vaccinations for Pregnant Women

OD 0355/11 - Vaccine Cold Chain Guidelines

OD 0237/09 - Hepatitis B Vaccination Program

OD 0388/12 - Health Care Worker Immunisation Policy

Policy Frameworks: Public Health

Reporting adverse reactions: Western Australian Vaccine Safety Surveillance (WAVSS)

Related WNHS policies, procedures and guidelines

Anaesthetics: Anaphylaxis (available to WA Health employees through Healthpoint)

Infection Prevention and Management Policy Manual:

Vaccinations

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Hand Hygiene

Standard Precautions

Neonatology Postnatal Ward guidelines:

Maternal Hepatitis B Virus (HBV): Care of the infant born to HBV positive women

Maternal Hepatitis B Virus (HBV): Quick Reference Guide

Obstetrics & Gynaecology:

Clinical Deterioration

Pathology & Ultrasound: Ordering by Midwife / Nurse / Nurse Practitioner: Antenatal

tests, Ordering

Pharmacy:

Pertussis Vaccine

Fridge Medications and Vaccines (access to WA Health employees through

Healthpoint)

Medication Administration (administration and checking procedure by nursing /

midwifery staff) (access to WA Health employees through Healthpoint)

Resources

Australian Government:

Immunisation website including resources for:

Consumers:

o Influenza vaccine - video and Influenza vaccine – brochure

o Whooping cough vaccine - video and Whooping cough vaccine – brochure

Health care providers

o Clinical advice fact sheet for providers

o Whooping cough vaccine - poster

o Influenza vaccine - poster

National Pregnancy Care Guidelines: Rubella

Australian Technical Advisory Group on Immunisation (ATAGI). Australian Immunisation

Handbook, Australian Government Department of Health, Canberra. 2018. Retrieved

from https://immunisationhandbook.health.gov.au including sections on:

Rubella

Table of Recommended intervals between immunoglobulins or blood products,

and measles-mumps-rubella, measles-mumps-rubella-varicella or varicella

vaccination

Vaccination for people who have recently received normal human

immunoglobulin and other blood products

Vaccinations

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E-learning- Australian Immunisation Register education modules [external site] (for

Health professionals)

Government of Western Australia. Department of Health:

Consent Process For Vaccination

Immunisation Schedule

Immunisation Education webpage (immunisation videos, courses, and online

annual influenza updates for health professionals)

Public Health: Take 5’s- Anaphylaxis: A Guide for Healthcare Workers Influenza

Program Vaccinators and Managing a Cold Chain Breach (available to WA

Health staff through Healthpoint)

Public Health and Clinical Services. Vaccine Administration Code January 2016

National vaccine storage guidelines: Strive for 5. 2nd ed. Canberra: Australian

Government Department of Health and Ageing, 2018. (last updated April 2018)

Keywords: AN Vaccines, Vaccinations in Pregnancy, Pertussis vaccine, Influenza vaccine; MMR. Measles, mumps, rubella, vaccination, low immunity, non-immune, immunisation, hepatitis b immunoglobulin, HBIG, neonatal immunisation, neonate of hep B positive mother, perinatal transmission, neonatal IM injection, Neonatal Hepatitis B, Hep B vaccine, HBV, Australian Immunisation schedule, neonatal medication

Document owner: Obstetrics Gynaecology and Imaging Directorate (OGID)

Author / Reviewer: Microbiology/ Infectious Diseases Consultant; CNMM Ambulatory Services; CMC Maternity Wards; KEMH Midwife Immunisation Provider; HoD Obstetrics

Date first issued: May 2019 [amalgamated 4 separate guidelines]

Version: 1.0

Last reviewed: Next review date: May 2022

Supersedes: History: In April 2019, four individual guidelines on medication administration were amalgamated dating from Sept 2001.

Supersedes:

1. Antenatal Vaccination Protocol: Pertussis and Influenza (date last amended Aug 2017)

2. Measles, Mumps and Rubella (MMR) Vaccine Administration (dated May 2014)

3. Neonatal Care: Hepatitis B Vaccine (date last amended Feb 2015)

4. Neonatal Care: Hepatitis B Immunoglobulin (date last amended Feb 2015)

Endorsed by: Maternity Services Management Sub Committee (MSMSC)- OOS

Date: 01/05/2019

NSQHS Standards (v2) applicable:

1 Governance, 2 Partnering Consumers, 3 Preventing and Controlling

Infection, 4 Medication Safety, 6 Communicating (incl )

Printed or personally saved electronic copies of this document are considered uncontrolled.

Access the current version from the WNHS website.